Rana Majeed, Moellmann Henriette L, Schorn Lara, Lommen Julian, Rana Madiha, Wilkat Max, Hufendiek Karsten
Department of Oral and Maxillofacial Surgery, Heinrich Heine University Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany.
Department of Psychology, University of Applied Sciences, Doberaner Weg 20, 22143 Hamburg, Germany.
J Clin Med. 2022 Jun 11;11(12):3361. doi: 10.3390/jcm11123361.
Contemporary advances in technology have allowed the transfer of knowledge from industrial laser melting systems to surgery; such an approach could increase the degree of accuracy in orbital restoration. The aim of this study was to examine the accuracy of selective laser melted PSIs (patient-specific implants) and navigation in primary orbital reconstruction. Ninety-six patients with orbital fractures were included in this study. Planned vs. achieved orbital volumes (a) and angles (b) were compared to the unaffected side (n = 96). The analysis included the overlay of post-treatment on planned images (iPlan 3.0.5, Brainlab®, Feldkirchen, Germany). The mean difference in orbital volume between the digitally planned orbit and the postoperative orbit was 29.16 cm3 (SD 3.54, presurgical) to 28.33 cm3 (SD 3.64, postsurgical, t = 5.00, df = 95.00; p < 0.001), resulting in a mean volume difference (planned vs. postop) of less than 1 cm3. A 3D analysis of the color mapping showed minor deviations compared to the mirrored unaffected side. The results suggested that primary reconstruction in complex orbital wall fractures can be routinely achieved with a high degree of accuracy by using selective laser melted orbital PSIs.
当代技术的进步已使知识从工业激光熔化系统转移至外科手术；这种方法可提高眼眶修复的精确程度。本研究的目的是检验选择性激光熔化的个性化植入物（patient-specific implants，PSIs）及导航在眼眶一期重建中的准确性。本研究纳入了96例眼眶骨折患者。将计划的与实际获得的眼眶容积（a）和角度（b）与未受影响侧（n = 96）进行比较。分析包括将治疗后的图像叠加在计划图像上（iPlan 3.0.5，Brainlab®，德国费尔德kirchen）。数字化计划眼眶与术后眼眶之间的平均眼眶容积差异为29.16 cm³（术前标准差3.54）至28.33 cm³（术后标准差3.64，t = 5.00，自由度df = 95.00；p < 0.001），计划与术后的平均容积差异小于1 cm³。颜色映射的三维分析显示与镜像的未受影响侧相比存在微小偏差。结果表明，通过使用选择性激光熔化的眼眶个性化植入物，复杂眼眶壁骨折的一期重建可常规实现高度精确性。
